Radiology Department, Centre Diagnòstic per la Imatge (CDI), Hospital Clinic de Barcelona, Barcelona, Spain.
Universitat de Barcelona, Barcelona, Spain.
Transpl Int. 2024 Aug 6;37:12682. doi: 10.3389/ti.2024.12682. eCollection 2024.
Duodeno-duodenostomy (DD) has been proposed as a more physiological alternative to conventional duodeno-jejunostomy (DJ) for pancreas transplantation. Accessibility of percutaneous biopsies in these grafts has not yet been assessed. We conducted a retrospective study including all pancreatic percutaneous graft biopsies requested between November 2009 and July 2021. Whenever possible, biopsies were performed under ultrasound (US) guidance or computed tomography (CT) guidance when the US approach failed. Patients were classified into two groups according to surgical technique (DJ and DD). Accessibility, success for histological diagnosis and complications were compared. Biopsy was performed in 93/136 (68.4%) patients in the DJ group and 116/132 (87.9%) of the DD group ( = 0.0001). The graft was not accessible for biopsy mainly due to intestinal loop interposition (n = 29 DJ, n = 10 DD). Adequate sample for histological diagnosis was obtained in 86/93 (92.5%) of the DJ group and 102/116 (87.9%) of the DD group ( = 0.2777). One minor complication was noted in the DD group. The retrocolic position of the DD pancreatic graft does not limit access to percutaneous biopsy. This is a safe technique with a high histological diagnostic success rate.
十二指肠胃吻合术（DD）已被提议作为胰腺移植中替代传统十二指空肠吻合术（DJ）的更生理的选择。这些移植物中经皮活检的可及性尚未得到评估。我们进行了一项回顾性研究，纳入了 2009 年 11 月至 2021 年 7 月期间所有要求进行的胰腺经皮移植活检。只要可能，在超声（US）引导或 US 方法失败时在计算机断层扫描（CT）引导下进行活检。根据手术技术（DJ 和 DD）将患者分为两组。比较了可及性、组织学诊断成功率和并发症。DJ 组中有 93/136（68.4%）的患者进行了活检，DD 组中有 116/132（87.9%）的患者进行了活检（=0.0001）。由于肠袢插入（n=29 DJ，n=10 DD），活检无法进行主要是因为肠袢插入。DJ 组中有 86/93（92.5%）和 DD 组中有 102/116（87.9%）的患者获得了足够的组织学诊断样本（=0.2777）。DD 组中有 1 例轻微并发症。DD 胰腺移植物的结肠后位置并不限制经皮活检的可及性。这是一种安全的技术，具有较高的组织学诊断成功率。
